Check-up and Cleans

The dental check-up is the cornerstone of dentistry. Many issues can be identified and either prevented or treated early with regular check-ups. In addition your dentist can guide you in how to care for your teeth at home. The dentist may also take the time to clean away stubborn plaque and calculus which cannot be brushed away. This helps to prevent decay starting as well as helping to limit gum disease (gingivitis and periodontal disease). Often the dentist will advise radiographs (x-rays) to check bone levels and in-between back teeth and they may apply fluoride at the end.

 

Fluoride

Fluoride is an essential part of dental treatment and prevention. It is used in many different forms to help keep teeth healthy and strong. 

  • Professional fluoride application: Gels, foam or varnish applied by your dentist will help prevent decay and/or remineralise early decay or at-risk areas.  6-monthly application of fluoride gels resulted in a 28% reduction in decay experience in adult teeth (Marinho V et al).
  • Water fluoridation: Hailed by the US Centre for Disease Control (CDC) as one of the top 10 public health achievements of the 20th century, water fluoridation has been shown to dramatically reduce the incidence of decay by up to 40%, even in developed countries which have access to fluoridated products.
  • Toothpastes: When used in conjunction with fluoridated water it has an additive effect. This should be used twice a day. Your dentist will let you know the appropriate toothpaste for you. 
  • Mouthrinses: The use of fluoride mouthrinses should be used in addition to (not instead of) fluoride toothpaste in those with a higher risk of dental caries.

 

Dental radiographs (X-rays)

Bitewing radiograph: The arrows show small shadows starting between the teeth. This person needs to floss more!! © Dr Vickers

“X-rays” actually refer to the radiation emitted from the x-ray machine. The actual image produced is known as a “radiograph.” Radiographs are vital to diagnosis and treatment in dentistry. Many treatments cannot be performed (both practically and legally) without dental radiographs.  The most commonly used dental radiographs include:

Periapical film: Shows an abscess at the base of the tooth. © Dr Vickers

  • Bitewings: These are the most common dental radiographs, usually taken every few years at a routine check-up or at your first visit. These help detect the presence of decay between the back teeth (where the dentist cannot see well) and to help confirm the level of supporting bone.
  • Periapical films: These show the entire tooth, including the root and the bone surrounding the tooth. They are excellent for identifying infection at the base of teeth and can be used to assess more extensive bone loss.
  • Panoramic films (OPG): This film gives a view of the entire upper and lower jaw.  It is particularly important;
    • Prior to orthodontic treatment
    • For patients requiring dentures and other full mouth treatment
    • To assess the position of wisdom teeth
    • To assess trauma and pathology in the jaw

 

FAQs - Fluoride

What is Fluoride?

Fluoride is a variation of the element Fluorine. Naturally occurring as Fluoride in nature, it is the 13th most common element on Earth. It occurs naturally in the soil and water (long before humans purposely added it to our drinking supply) and in many plants and animals, including in human body and skeletal tissues.

 

How does Fluoride help teeth?

  • During formation: In low quantities it is incorporated into the tooth enamel during formation. 
  • Protection from decay: When a tooth is exposed to fluoride, a reservoir of calcium fluoride is formed on the tooth surface which can be released for remineralisation. It essentially hardens the weakened enamel in early decay.
  • Antibacterial action: Fluoride has been shown to interfere with the metabolic activity and growth of decay-causing micro-organisms.

 

Is fluoride harmful?

 Like many things in life (such as medication and food) a little bit may be beneficial, but too much can make you sick or have side effects. Fluoride is much the same. When used as directed, it is completely safe. 

 

Is infant formula and baby food safe?

Today the concentration of fluoride in pre-prepared formula and baby food is very low. If your baby is fed primarily powdered infant formula mixed with fluoridated water there is a slight chance for mild enamel fluorosis. While the official guidelines say that it’s safe, if you’re concerned you can alternate between fluoridated and non-fluoridated water. 

 

Do other food and beverages contain fluoride?

Interestingly, soft drinks, beer and re-constituted fruit juices prepared in fluoridated areas will have fluoride levels very close to that of drinking water. However this does not negate the damage from the acid and sugar content. Meat and seafood are high in fluoride while some food will contain trace amounts of fluoride if they are processed in fluoridated areas.

 

Why is there opposition to fluoridation?

Much of this opposition stems from a lack of scientific understanding. Some people oppose fluoridation on moral grounds, considering it “mass medication” and saying that it should be their right to choose, despite the overwhelming data showing the social benefits.

 

What about Fluoride tablets?

Today these are considered unnecessary.

 

FAQs - X-rays

How are radiographs produced?

Radiographs are produced by passing x-rays through the teeth and then exposing the film behind them. Cavities, decayed tooth structure and infection, will allow more x-rays to pass through than healthy tooth and bone and will appear as more “shadowy.” 

 

Are x-rays harmful?

Radiation exposure is greatly reduced today with modern equipment, high-speed films and filters built-in to machines. In fact, the radiation received from one dental radiograph is equivalent to about 1/3rd the daily background radiation we receive from things like building materials, outside radiation and even food.

 

Are x-rays safe during pregnancy?

Overall, the risks of radiation and damage on an unborn child are extremely low. In cases where a radiograph is required to treat infection, failure to diagnose a problem with a radiograph may lead to untreated infection, which may actually be more harmful to the baby. Many dentists may use a lead apron to minimise these risks further. Where possible a dentist may choose to defer radiographs until the baby is born, just to be on the safe side. If you are considering having a baby, getting radiographs done before falling pregnant is always preferred, to minimise the need for having them during pregnancy.

 

If x-rays are safe, then why does the dentist leave the room every time?

The effects of radiation damage are cumulative. This means that exposure to the same amount of radiation in a concentrated dose versus numerous gradual doses, may cause similar damage over time. Thus, in working with x-rays all day, the dentist steps out of the room when taking a radiograph to avoid cumulative doses.